two weeks - BFAR

Declan is two weeks old!

We had a follow up appointment on Monday to check his weight. He has gained two ounces since our last appointment, which sounds great, but is not exactly the gain we were hoping for.

Ideally babies should gain four to eight ounces a week. Declan's two ounces does not meet expectations at this point. It's a step in the right direction, but  it means we have to really work at the new plan to help him gain more. This plan includes using more supplementation in the SNS while he is on the breast and pumping a minimum of ten minutes after each feed. Our pediatrician/IBCLC wants me to make sure I get enough sleep, eat well, stay hydrated, and makes sure I don't burn myself out, which is a delicate balance.

I know a few people wonder why I don't just forgo breastfeeding and switch to the bottle. Or just forget breast milk and switch to formula. I know for many people it seems like an easier choice. I have never been one to take the easy road, especially when it's something I feel passionate about. Will it be easy? No. Will it be worth it? In my eyes, yes.

I am a BFAR woman. I'm breast feeding after a reduction. I had a breast reduction in December of 2002. I was 19. At the time I was told it was either a breast reduction or back surgery, and at 19 that was an easy choice. It would still be an easy choice at 30. I knew going into the surgery that breast feeding may or may not be possible and if it were possible I could struggle with it.

When Silas was born I struggled with it. I had difficulty producing milk and worked with an IBCLC who was also a pediatrician. She gave me so much hope. We worked on a plan to give Silas what I could by pumping and supplementing with formula. I pumped for three months and kept Silas to the breast as long as I could, but our breast feeding relationship struggled. I didn't take it well, especially have all of my other complications from his cesarean section.

When I fell pregnant with Declan I contacted Dr. Jones right away. We switched over to her care as our pediatrician after Silas was a month old so it was easy to see her at one of his appointments. We made a plan for Declan right away. I would see her as soon as I could after he was born, I would take a medication to help build my supply, and I would gain access to a pump.

I was prepared for Declan to lose weight. I knew that I would need to supplement and we started as soon as we returned home. My wonderful sister has been able to supply us with breast milk and because it's of newborn content and I know the source I felt very comfortable using her milk. Thanks to the supplement he gained weight, but not quite enough. At our first pediatrician appointment we learned that Declan had a lip and tongue tie making it difficult for him to eat on the breast and on the bottle.

Our first action was to get the tongue tie corrected, and that has helped his latch. Unfortunately he had caused a lot of nipple trauma so latching him is still painful. We are waiting for the lip tie to be corrected and hopefully that will keep him from ripping my nipples up. Our pediatrician/IBCLC wants me to use a shield to allow my nipples to heal. There are concerns about babies becoming addicted to the shield, but our intention is to wean him from it once the healing process is completed. The next steps included feeding every three hours and supplementing using a bottle.

Of course Declan didn't gain as much weight as we had wanted, so we came up with a new plan which we will reevaluate at next week's weight check. My nipples are not yet healed so I'll continue to use the shield, but instead of supplementing with the bottle I will try to supplement using the SNS. Dr. Jones was able to explain how to use it with the shield at the same time. When I don't use the SNS I will use a bottle that Declan will tolerate, which at this time is the Dr. Brown bottle (so far it's the one that he spits up with the least). I will keep him at the breast for 20 minutes at each breast and then pump for 10 minutes after to stimulate production.

It sounds like a lot, but it's worth it to me. It's worth it to keep at it so I can build a supply that will sustain him, or at least a supply that with supplementation will continue to satisfy him. I feel empowered to know I can feed my child with my body, even if I need a little extra help. I'm grateful for the women who have offered their breast milk. I'm grateful for the support from my amazing husband. I'm grateful to the people who support me in breast feeding even though it's something I struggle with.

I know there will always be people who don't get it, but this is something important to me. I have no idea how long I'll be able to do it, but right now my goal is three months. To make it where I did with Silas. Once I get there I will  make another goal. I don't know what that goal will look like since I will be back at work, but we'll cross that bridge when we get to it.